10/26/2013

Q. My self-employed husband is covered under my insurance plan at work. I am looking at retirement and the spousal insurance cost for retirees is more than $800 per month, which is 40 percent of my retirement income. Would he be eligible for the exchange?

A. He likely is. Almost anyone can buy a health plan on the health insurance marketplaces, also called exchanges, which will open next month. The real question is whether he would be eligible for a premium tax credit to make the plan more affordable.

Endnotes and citations are available in the PDF version of this issue brief. Download the report: PDF Read it in your browser: Scribd

The United States suffered from numerous extreme weather events in 2011 and 2012. In fact, there were 25 severe storms, floods, droughts, heat waves, and wildfires that each caused more than $1 billion in economic damages, with a total price tag of $188 billion. To help communities recover from these violent weather events, the federal government spent nearly $62 billion for disaster relief in fiscal years 2011 and 2012. These federal funds only cover a portion of recovery costs; private insurance and individuals harmed by the events also spent billions of dollars.

There is recent evidence that climate change played a role in the extreme weather events of 2012. The recently released analysis from the American Meteorological Society determined that:

10/21/2013

The Center for American Progress released a report called “4 Ways that Austerity Demands Have Reached New Extremes,” which notes that the House Republican caucus is now proposing “spending cuts … so severe that the House Republican caucus has been unable to pass actual spending bills to implement its own budget plan, since those bills would have to make deep and specific cuts that are beyond the pale of what even most conservatives would support.” They are doing so based on the “claim that their demands for more austerity are a response to exploding budget deficits, but in fact, the federal budget deficit is shrinking, not growing.”

As Nobel Laureate economist Paul Krugman argued at length in The New York Review of Books, recent history both in Europe and the United States has proven conclusively that “the results [of austerity] were disastrous—just about as one would have predicted from textbook macroeconomics.” Not only has the experience of the nations that instituted austerity policies made their economic predicaments far worse than before, but the data upon which the arguments were made were also “deeply flawed.” The so-called Reinhart-Rogoff thesis—in which the authors insisted that large levels of government debt would inevitably result in much lower rates of economic growth—was discredited when the authors belatedly made their data widely available in April 2013.

10/17/2013

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Areas with large middle classes enjoy far more economic mobility than areas with small middle classes. Consequently, low-income children who grow up in regions with large middle classes are likely to become more financially successful than those who do not. This finding provides powerful new evidence that a strong middle class and economic opportunity go hand in hand.

Despite our plentiful political disagreements, Americans share a common commitment to equality of opportunity. Indeed, a remarkable 97 percent of Americans believe that every person should have an equal opportunity to get ahead in life.

Yet over the past few decades, a child’s chance of succeeding in life has become increasingly dependent on the circumstances into which he or she is born. Children of low-income parents tend to grow up to earn lower incomes themselves, while children of affluent parents tend to remain affluent. More than 4 in 10 children who start at the bottom stay at the bottom, and close to 4 in 10 children who start at the top stay at the top. If we aspire to give every child the chance to achieve the American Dream, we must do better. We must clearly understand the determinants of economic opportunity and craft solutions that will help to reignite it.

One of the health care overhaul's most far-reaching provisions prohibits health plans from refusing to cover people who are sick or charging them higher premiums. Still, for people with serious medical conditions, the online health insurance marketplaces present new wrinkles that could have significant financial impact.

Obviously, premium costs will be an important consideration for consumers. But just as important will be a realistic assessment of what kinds of out-of-pocket costs they could expect with different types of policies and what subsidies they will be eligible for.

"Everybody should be factoring in cost sharing along with the premium to try to assess what their total financial exposure is," says Jennifer Tolbert, director of state health reform at the Kaiser Family Foundadtion. (KHN is an editorially independent program of the foundation.)

Endnotes and citations are available in the PDF version of this report. Download the report: PDF Download introduction & summary: PDF Read it in your browser: Scribd

The shooting death of Trayvon Martin and George Zimmerman’s subsequent acquittal have focused the nation’s attention on expansive self-defense laws—so-called Stand Your Ground laws—that enable an individual to use deadly force even in situations in which lesser force would suffice or in which the individual could safely retreat to avoid further danger. Leaders from around the country, including President Barack Obama and U.S. Attorney General Eric Holder, have questioned how Florida’s law—which is similar to laws enacted in 21 other states—may have contributed to the circumstances that led to Martin’s death.

Endnotes and citations are available in the PDF version of this issue brief. Download the report: PDF Read it in your browser: Scribd

The fiscal debate hit a critical turning point on July 31, when leaders in the House of Representatives abandoned efforts to pass their transportation and housing spending bill after determining that a majority of House members opposed it. This typically routine legislation was an attempt by supporters of this year’s House budget resolution—authored by Rep. Paul Ryan (R-WI)—to implement the deep cuts to domestic programs required by their budget. The specific cuts to infrastructure investment, public safety, and protections for low-income Americans, however, were so severe that even members of Congress who voted for the abstract austerity of the Ryan budget opposed them. House Appropriations Committee Chairman Hal Rogers (R-KY), who runs the committee responsible for writing the spending bills to implement the Ryan budget, stated, “With this action, the House has declined to proceed on the implementation of the very budget it adopted just three months ago.”

Testimony Before the Subcommittee on Counterterrorism and Intelligence, Committee on Homeland Security

Endnotes and citations are available in the PDF version of this testimony. Download the report: PDF

Mr. Chairman and members of the subcommittee:

More than 12 years after the September 11 attacks, and two and a half years into the Middle East uprisings, the United States continues to face dangerous threats on a daily basis from that region of the world. Complicated security and political dynamics present new challenges for U.S. national security in the Middle East, and new threats posed by a number of Islamist terrorist networks affiliated with Al Qaeda in transition have emerged across the region.

That is why it is important to take opportunities such as today’s hearing to step back from the daily events, assess the security implications of the recent changes in the Middle East, and focus in on the overall status of the Al Qaeda network and the particular threats posed by Al Qaeda in the Arabian Peninsula, or AQAP.

The middle class remained historically weak last year, according to Census Bureau numbers released recently, as it continued to feel the effects of a decades-long slide driven in part by the decline in union membership across the country. Last year, the middle class’s share of the nation’s total income remained stagnant at its lowest point since these data were first reported: The middle 60 percent of households took home only 45.7 percent of the nation’s income in 2012, the same percent it took home in 2011 and well below the 53.2 percent it used to take home in 1968.

Driving this decline is a stagnation of middle-class incomes that has occurred at the same time that the nation’s highest earners have seen their incomes grow dramatically. Between 1967 and 2012, the average income of the top 5 percent grew by 88.2 percent in real terms, or three times the 26.6 percent growth experienced by the middle 60 percent. Middle-class incomes grew only slowly in the 1970s and 1980s but have now been in decline for some time, with the median household income in 2012 below the level it was in 1989. There are a number of reasons for this unequal growth, including increased globalization that has undermined middle-class wages and rising returns to higher education that have disproportionately grown the pay of those at the very top.

Among the most overlooked of these factors, however, has been the decline of labor unions. As Figure 1 shows, the fall in labor-union participation since the late 1960s is highly correlated with the decline in the share of the nation’s total income going to the middle class.

10/09/2013

While U.S. policymakers focus their attention on Syria’s civil war and the August 21 chemical weapons attack, Afghanistan is quickly approaching a political transition that will require sustained U.S. attention to be successful. Afghans will soon begin announcing their candidacies on September 16, and campaigning will follow in the lead-up to the presidential election scheduled for April 5, 2014—all in a volatile security situation and political environment. The U.S. foreign-policy establishment is rightfully concerned about the situation in the Middle East, but continued U.S. leadership in Afghanistan remains essential to ensuring a successful and peaceful transition process and maintaining the gains made by the United States and its allies. As the U.S. military draws down after more than 12 years of war, our job in Afghanistan is not done.

A series of recent developments have made Afghanistan’s first major transfer of executive power since 2001 from President Hamid Karzai to his successor more probable. These include the ratification of two pieces of parliamentary legislation that established an electoral architecture for Afghanistan: the establishment of an Independent Electoral Commission to organize the elections and the floating of potential candidates to succeed President Karzai. These developments come after a concerted push by Afghan leaders and civil society, the United States, and members of the international community, all of whom emphasized the importance of a credible election process and urged President Karzai to pass the electoral laws he had previously vetoed.

10/08/2013

Workers at small companies rarely get a choice of health plans. That could change for some of them when online health insurance marketplaces for businesses open this fall.

The health care overhaul requires every state and the District of Columbia to establish a Small Business Health Options Program, or SHOP exchange, to enable businesses with 50 or fewer workers to offer health insurance to their employees. These exchanges will function much like the online marketplaces for individual coverage that will open this fall, but with some key differences.

Since small employers lack the buying power of larger companies, the insurance plans they offer are often limited and their administrative costs are high. The SHOP exchanges are intended to make it easier for small businesses to offer their employees a variety of good plans, something employees prize.

"[Plan choice] is a big value added for workers," says Linda Blumberg, a senior fellow at the Urban Institute Health Policy Center who co-authored a report on shop exchanges.

Through the exchanges, employers will be able to designate how much they want to contribute toward their employees' coverage, and the exchange will handle the back-office functions, such as making sure the payments get to the correct insurance company. Employees, meanwhile, will be able to compare plans' features and costs online and enroll in a plan.

At least, that’s the way it eventually is supposed to work nationwide. In June, though, the Department of Health and Human Services announced that in the 33 states where it is running the health insurance marketplaces, it would delay for a year giving workers the ability to choose among different plans. HHS said that option would be too complicated for insurers to implement by 2014.

In the remaining states and the District of Columbia, the SHOP exchanges are all generally moving forward with plans to allow employers to offer their workers more than one coverage option. How much choice workers have will be up to the employers and the states, however.

Workers may be able to choose any plan offered by a single carrier such as Aetna or UnitedHealthcare on the SHOP exchange, for example, or they may instead be able to pick any insurer but be limited to plans that are all at the same level or tier. (Health plans will be grouped into four tiers based on how much of their medical claims consumers will be responsible for: In a platinum plan, consumers will owe 10 percent of the costs; in a gold plan, 20 percent; silver, 30 percent, and bronze, 40 percent.) In some states, employers can choose to offer employees just one plan.

10/04/2013

As Congress prepares for yet another fiscal showdown, new data released by the U.S. Census Bureau should be a wake-up call that it is time to move away from a wrong-headed austerity agenda and pivot to a focus on creating jobs, boosting wages, and investing in family economic security.

The new data on poverty and income show that despite economic growth, there was no statistically significant improvement in the poverty rate or median household income in 2012.

Behind these topline numbers are data that contain real warning signs for American families and the overall economy if Congress continues down its current path.

Here are three things you need to know about the new data and how they affect the budget and policy choices before us:

Income inequality has widened since the end of the Great Recession.

Our safety net is working overtime to compensate for rising income inequality and the proliferation of low-wage work.

High poverty rates among young children of color have long-term implications for our economic competitiveness.

10/03/2013

Rod Coons and Florence Peace, a married couple from Indianapolis, pay $403 a month for a family health plan that covers barely any of their individual medical care until each reaches up to $10,000 in claims. And that’s just the way they like it.

"I'm only really interested in catastrophic coverage," says Coons, 58, who retired last year after selling an electronic manufacturing business. Since they're generally healthy, the couple typically spends no more than $500 annually on medical care, says Coons.

"I'd prefer to stay with our current plan because it meets our existing needs."

That won’t be an option next year for Koons and Peace. In 2014, plans sold on the individual and small group markets will have to meet new standards for coverage and cost sharing, among other things. In addition to covering 10 so-called essential health benefits and covering many preventive care services at no cost, plans must pay at least 60 percent of allowed medical expenses, and cap annual out-of-pocket spending at $6,350 for individuals and $12,700 for families. (The only exception is for plans that have grandfathered status under the law.)

Plans with $10,000 deductibles won’t make the cut, say experts, nor will many other plans that require high cost sharing or provide limited benefits, excluding prescription drugs or doctor visits from coverage, for example.

Health care reform has enormous potential to improve access to health insurance coverage for millions of Americans, including many lesbian, gay, bisexual, and transgender, or LGBT, people and their families. Thanks to the Affordable Care Act, LGBT community members across the country can expect real improvements in the affordability and quality of their coverage—and many LGBT people will gain access to comprehensive and affordable health insurance for the first time.

Out2Enroll is an initiative of the LGBT State Exchanges Project at the Center for American Progress, the Sellers Dorsey Foundation, and the Federal Agencies Project. We’re working with advocates and organizations across the country to spread the word about the Affordable Care Act and to help connect people and their families with their new coverage options under the law. One of the biggest opportunities for new coverage under the Affordable Care Act comes from the Health Insurance Marketplaces, which will offer coverage in every state starting January 1, 2014.

10/02/2013

Although ESPN sports writer Jason Whitlock is not a personal favorite, there’s something compelling about his look-at-me writing approach to all things in the sports world. In the same way that motorists feel forced to rubberneck at calamity along the highway, Whitlock drives people to notice his antics, which often result in controversy over the point he’s trying to make. But last week, Whitlock’s showboating actually managed to draw attention to important issues: the corporate exploitation of young black men in sports and an ignorance of the historical importance of black athletes.

Some seniors think Medicare made a mistake. Others are just stunned when they find out that being in a hospital for days doesn't always mean they were actually admitted.

Instead, they received observation care, considered by Medicare to be an outpatient service. Yet, a recent government investigation found that observation patients often have the same health problems as those who are admitted. But the observation designation means they can have higher out-of-pocket expenses and fewer Medicare benefits.

More Medicare beneficiaries are entering hospitals as observation patients every year. The number rose 69 percent in five years, to 1.6 million nationally in 2011, according to the most recent federal statistics. At the same time, Medicare hospital admissions have declined slightly.

Here are some common questions and answers about observation care and the coverage gap that can result. (Seniors enrolled in Medicare Advantage should ask their plans about their observation care rules since they can vary.)

09/30/2013

As the state health insurance marketplaces, also called exchanges, get set to launch in October, many people have questions about the coverage that will be offered there. Here are a few that were posed to me recently.

Q. Are there unintended consequences of shopping through an exchange? For example, are the benefits of a plan with a lower monthly premium less comprehensive than the benefits of an expensive plan? And are there plans available only to people who qualify for subsidies, so that once income increases, the consumer must switch to a different plan?

Alarmed by the explosion of high-cost lending in the state, cities across Texas have passed ordinances to prevent the cycle of debt that short-term, high-cost loans can create.

But some big lenders are finding clever ways around the laws 2013 like giving away cash for free.

TitleMax promises to "make getting cash easy!" To get a loan, borrowers with "good credit, bad credit, or no credit" need only turn over the title to their car.

In Dallas, San Antonio, and Austin 2013 which have all passed lending laws 2013 those loans have come with zero percent interest.

What's the catch? After 30 days, the loan is due in full. If the borrower cannot pay 2013TitleMax's average loan is for $1,300 2013 the borrower is sent to another TitleMax location outside of the city, where he or she can receive a new, unrestricted loan. That loan, states a contract given to one borrower, could have an annual rate as high as 310 percent.

When people are forced to choose between protecting their safety and guarding their civil rights, almost everyone picks safety. After all, what good are rights if you’re injured or dead?

In the days after the terrorist attacks of September 11, 2001, many policymakers used this forced choice to argue for new surveillance laws such as the Patriot Act. The law gave the government sweeping new powers to spy on Americans by wiretapping, seizing financial records, tracking Internet activity, and more; but these measures, we were told, were a necessary trade-off for security.

The FBI also paid informants to infiltrate mosques and set up sting operations that were supposed to catch terrorists in our midst. Yes, the informants were sometimes the ones to suggest violent jihad in conversations with mosque goers. In one case, members of a California mosque were so alarmed that they reported an informant to the FBI. But we were told that the “war on terror” demanded aggressive tactics.

Racial and religious profiling, particularly at airports, followed a similar pattern. Folks who looked “Muslim”—whatever that means—were more likely be to stopped, questioned, and detained based on nothing more than their name, clothing, or skin color. But hey, that was the price for keeping our country safe.

09/29/2013

Some members of Congress are threatening a government shutdown on October 1 unless a new round of spending cuts is enacted—cuts that ignore the nation’s true, improved fiscal and economic outlook. Federal budget deficits have actually shrunk dramatically in recent years. The national debt is no longer on the brink of exploding. But our economy continues to struggle; the Census Bureau recently reported that income inequality is growing while middle-class wages are stagnant. The 15 charts in this column illustrate how much the fiscal picture has changed, and why—in order to get the economy back on track—the debate must change with it.

Note: Click on any of these charts to download them as .pdf files.

In 2010, the nonpartisan Congressional Budget Office, or CBO, projected exploding annual budget deficits and cumulative national debt. Policymakers on both sides agreed that stabilizing the federal budget had to be a high priority, so Congress enacted legislation that will reduce deficits by about $2.5 trillion over the next 10 years—not including the automatic spending cuts known as the “sequester.” Congress cut spending by $1.5 trillion and raised about $630 billion in new revenues. Taken together, these actions will reduce government spending by an additional $400 billion by reducing interest costs for the national debt. Due in part to these policy changes, annual budget deficits and cumulative national debt are both stable over the medium term.

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